"I am but mad north-north-west: when the wind is southerly I know a hawk from a handsaw." --Hamlet, Act II, scene ii.

Wednesday, 31 December 2008

Pediatrics publishes a critique of an "anti-vaccine" book

I've tended not to write anything about vaccines, partly because it's a long way from my field of expertise, and partly because it brings out the internet loons in greater numbers than almost anything else. Still, I ran across this via Ben Goldacre's miniblog, and it overlaps with my interest in scientific publishing: Pediatrics, the official journal of the American Academy of Pediatrics, has published an article by Paul Offit and Charlotte Moser. The article is highly critical of "The Vaccine Book: Making the Right Decision for Your Child", by Dr. Robert Sears, also known in media-friendly mode as Dr. Bob in his role as one part of "America's family of pediatricians". This is something that I haven't seen before: the journal of a learned society publishing a rebuttal of a popular health book. The article goes through Dr. Sears's book, and picks out misleading statements, flawed logic and questionable assumptions, particularly concentrating on the alternative vaccine schedules suggested in the book.

It seems unlikely that worried parents will pick up this article; they are much more likely to read the book. But perhaps by putting these arguments in one place in Pediatrics, it makes it easier for pediatricians themselves to counter the arguments against vaccines that they hear from parents. It might even be possible to give parents the article to look through. And many of the arguments in Dr. Bob's book ARE arguments against vaccines, in spite of the protestations of Dr. Bob himself. The paper is not written in overly technical language, although it does contain a lot of references that are unlikely to be easily available to the average concerned parent. It gives pediatricians a chance to say that actually mainstream scientific opinion does not agree with Dr. Bob. This is unlikely to do much to sway those who've drunk the anti-vaccine kool-aid and think that Dr. Offit is an unscrupulous shill of big pharma, willing to cause lasting harm to untold numbers of children in order to make money (just do a google search to see what I mean). But it might sway sensible people who have inevitably picked up doubts from the unbelievably incompetent reporting of the science surrounding vaccines in the media.

Perhaps it could be worth putting a similar article debunking the myths on MMR into something like the BMJ or the Lancet? Or perhaps something similar already exists and I've missed it?

Insightful comment. I picked up on the link and read the paper. I think you've raised an interesting issue here and I think that you are right.

It's fascinating that one of the comments lodged about the article is critical of what he seems to think is airing the AAP's dirty-washing in public, "I find it highly unusual that a fellow AAP pediatrician is roundly critized in Pediatrics (the flagship journal of the AAP) without a chance to address the claims."

An odd comment when the book is (at least) implicitly critical of those in the AAP who take an evidence-based position. I also wonder whether Dr Bob ran his book past people within the AAP effectively criticised by the book prior to publication? It seems to me that he got his criticism in first and now he and his friends are sore about being challenged.

As you say the Big Farmer gambit ( and argument from popularity!) is already in evidence.

I'm a bit more optimistic about the article being accessible to the lay audience. It's freely available, as are a lot of the references. Whether those who would benefit would be willing to give this 'university of google' lesson a fair read is, perhaps, the biggest difficulty.

(small blog pimp, sorry: I've put up a list of references from a note in Offit's excellent book, Autism's False Prophets, for "Studies exonerating MMR". All but one or two are freely available)

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Welcome to Hawk/Handsaw...

This is the blog of Paul Wilson. You can find science- and pseudoscience-related things here, as well as occasional posts on my current research. There is also some stuff about what I do in my spare time (mostly cycling and complaining about politics).